Facet Joint Injections, Medial Branch Nerve Blocks, and Radiofrequency Ablations (RFA)/Neurotomies
Facet joint injections, medial branch nerve blocks, and radiofrequency ablations (also known as neurotomies) are procedures specifically designed to diagnose and treat pain originating from the small joints (known as facet joints) of the spine.
Medial Branch Nerve Blocks
Medial branch nerve blocks target the small medial branch nerves that supply the joints of the spine. These nerves have no motor function (they don’t control muscles), so blocking them won’t cause muscle weakness. Instead, they help relieve pain caused by arthritis in these joints. If the nerve blocks are effective but the pain relief is short-lived, we may repeat the procedure one more time. If the relief continues to wear off quickly, radiofrequency neurotomies may be recommended as the next step.
Facet Joint Injections
Unlike medial branch nerve blocks, which target the nerves connected to the joints of the spine, facet joint injections deliver local anesthetics and steroids directly into arthritic spinal joints to relieve pain. These joints, much like the knees, are lined with cartilage and surrounded by a protective capsule. Arthritic inflammation can cause these capsules to swell. Addressing this inflammation helps reduce pain. For the right patient, facet joint injections can provide significant relief and improve mobility.
Radiofrequency Neurotomies
Radiofrequency neurotomies gently interrupt pain signals, offering long-lasting relief. Using a needle similar to the one for nerve blocks, we carefully insert an electrode along the nerve and apply a tiny electric current. This temporarily blocks the nerve’s ability to transmit pain, providing relief for several months. As the effect gradually wears off, the procedure can be repeated about every six months.
We understand that undergoing any medical procedure can be daunting, but rest assured, our team is here to ensure your comfort and safety.
When to Expect Relief and How Long It Lasts
Facet joint injections typically begin working within a few days, as the steroid gradually reduces inflammation over time. For some patients, noticeable improvement might take up to a week. The effects can last several weeks to a few months, depending on the severity of the condition and individual response to the treatment.
Radiofrequency neurotomies start to work immediately but may take 2–3 weeks to reach their full effect, as the treated nerves gradually stop transmitting pain signals. Once the maximum benefit is achieved, many patients experience relief for up to six months.
While the pain is better controlled, it’s important to engage in physical therapy and exercises to strengthen the spine and improve joint mobility, helping to maintain results and enhance overall well-being. These procedures can be safely repeated if the pain returns. Maintaining good bone health and addressing conditions like osteoporosis can help slow the progression of arthritis in the spine over time.
Is Sedation Available?
These are minor, low risk procedures that typically do not require sedation and can easily be done with just local anesthetic. For those patients who prefer sedation, we offer sedation both in the office and in the surgery center.
Instructions Before the Procedure
2. Please let us know if there are any changes to your health, such as a new pregnancy, or if you start antibiotics before your procedure.
3. If you choose sedation in our office, plan for a friend or family member to drive you home afterward. They are welcome to wait in our comfortable waiting area during your procedure, or you can call them when you are ready to leave.
4. If you are going to have sedation in the surgery center or hospital, we will provide additional instructions.
Instructions After the Procedure
Rest and Activity:
- Take it easy on the day of your procedure. You can return to your regular activities the following day.
- Avoid operating heavy or potentially dangerous equipment on the day of your procedure.
- If you had sedation, plan to avoid driving for the rest of the day.
Alcohol: If you received sedation, please skip alcohol for the rest of the day.
Dressings: You can gently remove any adhesive bandages, like Band-Aids®, the day after your procedure.
Blood Thinners: You can restart your blood thinners the day after your procedure unless we have advised you otherwise.
Comfort at the Injection Site: It’s normal to feel some mild discomfort where you received the injection. Applying ice can help ease the soreness—just remember to wrap the ice in a cloth and avoid placing it directly on your skin. Refrain from using heat on the injection site on the day of your procedure.